What is the prognosis of pediatric sleep disorders?

Updated: Oct 09, 2018
  • Author: Sufen Chiu, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

Learning difficulties, emotional lability, attention deficits, disruptive behaviors, social and school impairments, family dysfunction, low self-esteem, depression, anxiety, cognitive dysfunction hyperactivity, irritability, and memory impairment represent common comorbidities of sleep disorders in children and often exert bidirectional or reciprocal influences. OSAS may lead to cor pulmonale, pulmonary hypertension, right-side heart failure, growth retardation, and failure to thrive.

The treatment of primary insomnia often is difficult. Associated anxiety is often responsive to psychotherapy. Narcolepsy is a lifelong illness. Cataplexy, hypnagogic hallucinations, and sleep paralysis may diminish in frequency over time.

Tonsillectomy and adenoidectomy relieve symptoms in about 70% of pediatric patients with OSAS. Continuous positive airway pressure (CPAP) is indicated for patients who partially respond to surgery or in whom surgery is contraindicated. A review of available treatments for OSAS in children revealed only a limited evidence base to support their use. Extremely limited data from randomized controlled trials are available to support the effectiveness of adenotonsillectomy, although this represents the current quasi-standard and first-line treatment for OSAS.

The success of therapy for delayed sleep phase syndrome (DSPS) depends to a large extent on the adolescent’s level of motivation. To prevent relapse of DSPS, the new schedule must be rigidly maintained.

Most children with parasomnias outgrow this condition when younger than 10 years or demonstrate a progressive decrease to a prevalence comparable to that of the adult population. Approximately 88% of all enuretic children outgrow this condition by the time they are aged 13 years. The prevalence of enuresis in patients aged 13 years is 2%, which is similar to the prevalence rate in the adult population.

For sleep disorder related to a general medical condition, the prognosis depends on treatment of the underlying condition. For sleep disorder related to substance use, prognosis depends on treatment of the addiction.


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